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Diagnosis

The doctor will ask about symptoms and medical history. A physical exam will be done. Most middle ear infections can be diagnosed by looking into the ear with a lighted instrument, called an otoscope.

The doctor will see if there is fluid or pus behind the eardrum. A small tube and bulb may be attached to the otoscope. This is to blow a light puff of air into the ear. The puff helps the doctor see if the eardrum is moving normally.

Other tests may include:

Tympanometry—measures pressure in the middle ear and responsiveness of the eardrum,
also used to check for fluid or pus

Tympanocentesis—used to drain fluid or pus from the middle ear using a needle, also used to check for bacteria

Treatment

Medication

Some doctors may take a wait and see approach. In some cases, the doctor may prescribe an antibiotic (oral or ear drops) for your child and ask you to use the medication if the pain or fever lasts for a certain number of days. This approach has been effective in decreasing unnecessary antibiotic use. Since viruses cause most ear infections, antibiotics won't make the infection go away faster. Most middle ear infections, including those caused by bacteria, tend to improve on their own in 2-3 days.

Other medications may include:

Pain relievers

Fever reducers

Anesthetic ear drops

Note:
Aspirin is not recommended for children with a current or recent viral infection. Check with your doctor before giving your child aspirin.

Decongestants and antihistamines are not recommended to treat ear infections.

Surgery

Myringotomy
is surgery done to open the eardrum. A tiny cut is made in the eardrum to drain fluid and pus.

Prevention

To help reduce the chance of getting a middle ear infection:

Avoid exposure to smoke.

Breastfeed your baby for at least the first 6 months of life.

Try to avoid giving your baby a pacifier.

If you bottle-feed, keep your baby's head propped up as much as possible. Don't leave a bottle in the crib with your baby.

Get tested for allergies if you or your child have chronic nasal congestion. Keep allergy symptoms well controlled.

Consider getting a
flu vaccine
.
Pneumococcal vaccine may prevent some ear infections, but the overall effect on ear infections is not known.
If your child has a history of ear infections, talk to the doctor about long-term antibiotic use.

Ask your doctor about tympanostomy tubes. These tubes help equalize pressure behind the eardrum and prevent fluid build-up and infection.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Ear infections in children.
National Institute on Deafness and Other Communication Disorders website. Available at:
hhttp://www.nidcd.nih.gov/health/hearing/pages/earinfections.aspx.
Updated February 2013. Accessed August 18, 2014.